Upon working within the Neonatal Intensive Care Unit saving the lives of premature and underweight babies from vulnerable communities in the 1990s, Dr Armida Fernandez came across a horrific case of rape on a six-week old baby. It was this that sparked the foundation of SNEHA (Society for Nutrition, Education and Health Action) – an organisation set up to empower and educate women and the issues they face in their societies. Encountering many women who were in abusive relationships while working in the NICU unit, it became clear that more needed to be done in terms of sending them back to these communities, and so SNEHA was born.
Almost 14 years after the beginning of SNEHA, their objective to change the attitudes, practices and behaviours in areas of maternal, child and adolescent health and the prevention of violence has impacted the lives of close to one million people across India. They have helped over 15,000 women to deliver safely and provided counselling to over 3,500 women who have been victims of violence.
In their program on child health and nutrition they have managed to reduce the levels of acute malnutrition in phase one of their Dharavi program by 18% in just 21 months, and despite focusing their work on those who live in informal urban settlements, the SNEHA team reinforce that they “provide support and help to any woman who reaches out to SNEHA for help.”
For SNEHA, education is their number one crucial factor along with raising awareness of the issues they deal with. Working towards bringing about improvements in the quality of health services and health-seeking behaviour, one of the biggest general misconceptions they have found from the families they have worked with is that malnutrition is not recognised as a “silent disease”. With around 46% of India’s children below the age of three suffering from malnutrition and being too small for their age, nutrition education is increasingly important for women and families raising children. To date, SNEHA have screened over 17,000 children under the age of 5 for signs of malnutrition and improved their standard of upbringing.
It is not just educating the families they come in to contact with that is important in terms of changing the way women and children look after their health in India, media and government support can make a huge difference. “There is some government support and media awareness, but it is not enough to match the magnitude of the problems. There is a great need to create awareness to make health “aspirational” and a priority for urban vulnerable communities,” says Vanessa D’Souza, CEO of SNEHA.
So far, the government run social welfare scheme, the Integrated Child Development Services (ICDS) has worked towards tackling malnutrition and health problems within children in India. However, their Anganwadis centres set up in order to do this only cater for children from 3 – 6 years of age, meaning infants and new-borns from the age of 0 – 3 years are left incredibly vulnerable. Their health is left “entirely dependent on the availability of the mother to breastfeed, the ability of the caregiver and household to provide nutritious meals, the quality of the public healthcare system and overall community support,” says Preethi Pinto from the SNEHA team, who continues that there is significant “scope for the scaling up and replication of this model”.
Urban informal settlements within India where SNEHA work seriously lack basic living needs for the people living in these communities making them unhealthy and unsafe environments often with a lack of access to public healthcare systems, hence the powerful need for the work that SNEHA do as Preethi explains:
“Lack of access to safe water, visible open sewers, limited pathways, uncontrolled dumping of waste and inadequate sanitation, can pose serious health risks, especially for young children.”
It is evident just how much of a social change SNEHA has made since its start and their aim to not only educate families in providing for their children but also supporting and providing a safe place that women suffering from domestic violence so desperately need makes their work invaluable.
One case that wouldn’t have been the same without SNEHA is that of Kavita* who was nine-months pregnant when she was admitted to hospital with 70-75% burns after her husband and in-laws set fire to her upon discovering that her family were unable to meet the dowry demands they were requesting. Kavita had suffered years of physical and verbal assault throughout her marriage but it wasn’t until this final horrific crime took place that awareness was brought to her case and the SNEHA team could get involved, helping Kavita learn that it was acceptable and important to press charges and get some justice for the crimes she had suffered. This was taken forward with a SNEHA counsellor who negotiated the victim’s statement and kept consistent efforts throughout her case, providing a physical presence in court and offering support and encouragement. With the majority of women in violent relationships keeping quiet for fear or the lack of knowledge of their rights, cases like this with SNEHA are fast changing this backwards norm and having a positive impact on the lives of women such as Kavita, making their futures a lot brighter.
*name changed to protect identity